This selection is one of Ernest Hemingway’s most brilliant and enduring, “Big Two-Hearted River.” The story deserves a patient, close reading; perhaps no better example of Hemingway’s distinctive prose style exists. Here’s how it begins:

The train went on up the track out of sight, around one of the hills of burnt timber. Nick sat down on the bundle of canvas and bedding the baggage man had pitched out of the door of the baggage car. There was no town, nothing but the rails and the burned-over country. The thirteen saloons that had lined the one street of Seney had not left a trace. The foundations of the Mansion House hotel stuck up above the ground. The stone was chipped and split by the fire. It was all that was left of the town of Seney. Even the surface had been burned off the ground.

Nick looked at the burned-over stretch of hillside, where he had expected to find the scattered houses of the town and then walked down the railroad track to the bridge over the river. The river was there. It swirled against the log spires of the bridge. Nick looked down into the clear, brown water, colored from the pebbly bottom, and watched the trout keeping themselves steady in the current with wavering fins. As he watched them they changed their again by quick angles, only to hold steady in the fast water again. Nick watched them a long time.

Scott Stossel reflects on his decision to open up about his chronic anxiety:

I revealed my anxiety and … the world didn’t end. Did friends and colleagues talk about me behind my back? Maybe. Probably. (O.K., definitely.) But for the most part people didn’t seem to treat me any differently — and to the extent that they did, it was to express sympathy or empathy and even admiration for my “bravery” in revealing my vulnerability. (This always struck me as odd because I was being brave only in revealing my lack of bravery, which is a cheap sort of bravery indeed.)

Many people — friends, colleagues, strangers — came forward to share their own stories of anxiety, and to say that my publicly revealing my anxiety somehow made them feel more hopeful, or less alone, and sometimes less anxious. This made me feel good, though I found it ironic that my writing about my anxiety seemed to reduce other people’s anxiety more than it did my own.

I’m still anxious. I still have bad episodes. I remain (lightly, for the most part) medicated. But Dr. W. was right: Coming out as anxious has helped. It has been a relief not always to have to do “impression management,” as Dr. W. calls it. I don’t — or don’t always, anyway — feel a desperate compulsion to hide the anxiety that sometimes overtakes me.

This subject is near-and-dear to my heart. I was a college athlete who never had to even think about what I ate to maintain low bodyfat. Then my workouts dropped to, say, 20% of what I had been doing when I stopped playing college bball and started working a full-time job. Typical story, I guess. The pounds crept on slowly, 5-10 a year, until, at 29, I was 50 pounds overweight. The weight came slowly but the realization came suddenly. I remember the first time I went to the beach and felt hesitation about taking my shirt off. Within a month, I was cringing every time I looked at myself shirtless in the mirror. I wasn’t obese, but I was fat, and I just didn’t like it, at all.

So I started doing actual research into what makes people fat, and it turns out, it’s not actually lack of exercise.

A sedentary lifestyle makes you very unhealthy, but it doesn’t really make you fat. The composition of your body is ~80% diet, ~10% exercise, and ~10% genetics. Upon realizing this, I started getting my diet under control. As a part of that, I started counting calories, and which macronutrients (protein, carbs, and fats) I was getting those calories from.

Two years later, I am down 60 lbs, ~11% body fat, and I will count calories every single day for the rest of my life. Far from a marker of female vanity, knowing what you are putting in your body should be one of the basic life skills that every single person possesses. The idea that people are shoving food into their mouths without even thinking about what’s in it or how much they’re eating is, when you think about it, insane.

Would people do that with their cars? Would they just start throwing into the tank different kinds of gas and oil and anything that looks like gas or someone told them was gas, without even keeping track of what they were putting in or how much? Of course not! That would be a crazy way to treat a valuable thing like a car. And it’s even crazier to treat your body that way. I’m not judging people who do; I did for a long time. But, when you think about it, it’s wild that people do that so blithely.

We have a food problem in this country. It’s destroying our health. It’s making people depressed. It’s going to cost us billions in health care over the coming decades. In order to solve this problem, we’re going to have to confront some basic realities that are currently being ignored. Such as: 1) The fast food joints and related businesses that litter out neighborhoods are actually selling poison. It seems strange, because they’re everywhere and advertise on TV, but that’s literally true. It’s a slow-acting poison, but if you keep putting it in your body, it makes you fat, unhappy, sick, and eventually dead. 2) Regular soda is the worst offender of all. And 3) It is crazy to go through life without tracking the fuel that you’re putting in your body.

Thanks as always for airing frank discussion.

Update from a reader:

I’d like to echo from a different perspective the former college athlete on the junk we put in our bodies. Eight years ago, when I was 54, I was told at my annual physical that I was diabetic. I didn’t fit the typical criteria for Type 2; in fact, I had just mysteriously dropped about 12 pounds. I went home from that appointment thinking, “What the hell do I eat now?”

Fewer carbs, of course, and just less. I put less on my plate to begin with, and found that I’d be fine without going back for seconds. No more “finishing off the last bits so there are no leftovers”. No desserts. (This from someone who definitely had a sweet tooth.) It sounds grim, but it wasn’t. We’re good cooks, and we make most things from scratch anyway. It gradually dawned on me that most carbs are just filler, and knowing that I was poisoning my body by eating them reduced their appeal significantly. (Potatoes and New Haven-style pizza excepted.)

It turned out I was Type 1, with my insulin production gradually declining. By the time I finally had to start taking insulin, four years later, I had lost another 25 pounds. Everyone thought I was too thin. I gained back about 15 pounds once I started on insulin, and it’s been steady for the last three years.

According to a recently released survey from the Pew Research Center, the public opinion on vaccine requirements, for example, divides much more by age than by political affiliation. This may be a function of the fact that younger people are less likely to have seen the diseases the vaccines are designed to protect against. (In other words, vaccines are victims of their own success.) However, the poll was worrying in one political respect: In 2009, there was no partisan difference in attitudes toward these requirements. The latest study did find some small differences along party lines. According to Brendan Nyhan, a Dartmouth political science professor who has done research on effective communication around vaccines, injecting partisan politics into individual decisions about whether to vaccinate could have unintended consequences. He argued in the New York Times recently that making the decision to vaccinate one of partisan allegiance could potentially push some individuals who might otherwise have vaccinated their children to forgo the process.

Seth Masket warns that “if enough Republican leaders or conservative cultural figures publicly question the importance of immunizations, and if such messages go unchallenged or even embraced by commentators on Fox and other conservative media outlets, that message could soon be adopted by conservative parents with only modest attachments to politics”:

And in some ways, this argument meshes very well with the American conservative world view. The idea that I can make better judgments about my kids than the government can, that I should be concerned about me and my own rather than the larger social network, that I shouldn’t have to make sacrifices or face risks on behalf of strangers — it wouldn’t take much to fold that into the definition of modern conservatism. Resistance to vaccinations doesn’t have to mean embracing organic food or breastfeeding toddlers; that’s simply a liberal interpretation of it.

But we’re not quite there yet. The main cultural elites advocating avoiding or at least questioning vaccinations, from doctors with celebrity pretensions to celebrities with medical pretensions, are mostly on the left right now. Chris Christie has limited appeal, and Rand Paul has not quite yet demonstrated an ability to reach those outside his libertarian circles. But if we’re going to see the anti-vaxxer belief system mutate and spread to the right, this will be how it happens.

I am enjoying Johann Hari’s Chasing the Scream very much. For the most part I find that the author backs up his views with solid evidence and logic.

However, the suggestion in Chapter 13 that a chaotic, abusive home and the parents’ failure to bond (attach) with the child is what causes addiction proves too much. Recent NIMH studies by Bridget Grant show that personality disorders persistently and robustly predict the persistence of substance abuse disorders. Grant’s work shows that roughly 50% of substance abusers meet the criteria for borderline personality disorder. There is good reason to believe that these individuals are quite resistant to treatment as usual.

It is fair to say that people with personality disorders feel isolated and alone. So, to that extent, Hari’s thesis has validity. And while early literature connected personality disorders to a chaotic home, abuse and a failure of attachment, the more current view is that these individuals may be so sensitive that they perceive chaos and abuse where others would not. And the failure to attach may be due to something inherent in the child rather the parent.

The point is that it is unfair, as Hari does in his book, to assume that because an addict feels isolated and reports an abusive or chaotic home, that this report is accurate. Sometimes, it is just the way the disordered person has misperceived the world.

Another reader:

I’ve gotten a little more than halfway through Hari‘s book, looking forward to actually being able to take part in the coming Book Club discussion, now never to happen. But the reading itself is worthwhile: What a marvelous book so far.